Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1528318631 Individual Practitioner Male Practitioner

Peter J. Stack , MSPT

Physical Therapist - Pediatrics • Providence, RI

Professional Overview & Biography Verified Profile Summary

Peter Stack, MSPT is a registered healthcare professional specializing in Physical Therapist - Pediatrics in Providence, RI. Practice services are available at 134 THURBERS AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

134 Thurbers Ave

Providence, RI 029054754

Telephone 4013311350
Fax 4012773366
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physical Therapist - Pediatrics in Providence, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
6 Specialists

Practicing in Providence, RI (11 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physical Therapist - Pediatrics Primary Specialty

NUCC Taxonomy Code: 2251P0200X

State License RI PT00331

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Carolanne Geffroy , LICSW

Social Worker - Clinical

NPI 1023330990

Licensed Independent Clinical Social Worker

Amy Modracek , RD

Dietitian, Registered

NPI 1033246574

Registered Dietitian

Mildred Bates , LICSW

Social Worker - Clinical

NPI 1033268438

Licensed Independent Clinical Social Worker

NPI 1033438056

Licensed Clinical Social Worker

Nicole Ortiz , LCSW

Social Worker - Clinical

NPI 1053158568

Licensed Clinical Social Worker

Diane Shemtov , LICSW

Social Worker - Clinical

NPI 1053453431

Licensed Independent Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 11, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location September 11, 2013

Registered at 134 THURBERS AVE, PROVIDENCE, RI 029054754 (Tel: 4013311350)

📍
Updated Business Mailing Address September 11, 2013

Registered at PO BOX 6688, PROVIDENCE, RI 029406688 (Tel: 4013311350)

👤
Provider Name / Credentials Updated September 11, 2013

Recorded as PETER STACK, MSPT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2013

Physical Therapist (License #PT00331 in RI)

🟢
Initial NPI Registration & Enumeration September 17, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1528318631
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 17, 2012
Last Update: September 11, 2013
Sole Proprietor: No

Mailing Address

Po Box 6688

Providence, RI 029406688

Phone: 4013311350

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.